Means Of Fertility Control Research Articles

English

Many rural and poor women have now resorted to use of potential medicinal plants as a means of fertility control. Asparagus africanus Lam and Annona senegalensis Pers are some of the plants used for this purpose. The efficacy and safety of many of such plants, however, have not been verified. Therefore, screening for anti-fertility activity of potential medicinal plants, would thus provide alternative safe and affordable contraceptive, if effective and less toxic. This study aims to carry out phytochemical screening, acute toxic effects and antifertility activity in female rats of the aqueous extracts of A. africanus Lam and A. senegalensis Pers combination. Acute toxicity test was done according to Lorke’s methods and antifertility activity of the extracts by use of the method described by Khanna and Chaudhary, with modification for our local use. The percentage inhibition of conception of the extract was compared with those of the controls. Phytochemical screening revealed the presence of known anti-fertility principles such as saponins, alkaloids and phenolic compounds. Acute toxicity studies indicated that the extract was non-toxic up to the highest dose of 12.8 g and the antifertility activity of the aqueous crude extract was found to be dose dependent. This study therefore demonstrated that the aqueous root extract of A. africanus Lam and A. senegalensis Pers combination has antifertility activity and is safe at the doses employed in this study. Key words: Anti-fertility, rats, phytochemical screening, acute toxicity, Asparagus africanus, Annona senegalensis.

Prevention of unsafe abortion in countries of Central Eastern Europe and Central Asia

Despite permissive laws and a well-developed network of facilities, the incidence of unsafe abortion and the resulting maternal mortality is unacceptably high in Central and Eastern Europe and Central Asia, with one-quarter of all maternal deaths reported to occur as a consequence of abortion. Among the reasons that oblige women to submit themselves to risky procedures are new legislative barriers to accessing pregnancy termination, the unequal distribution of abortion services and healthcare providers, the increased costs of abortion services or unofficial payments, coupled with an increase in the number of impoverished and disadvantaged individuals. The quality of abortion services remains very poor. Safe abortion techniques, including manual vacuum aspiration under local anesthesia and medical abortion, are slowly being implemented. Less safe methods such as dilatation and curettage and general anesthesia are widely used. Unsafe techniques are also practiced extensively in the case of second trimester abortions. Many women from these regions of the world still rely on and accept abortion as a means of fertility control. Although abortions have fallen significantly in Eastern Europe over the last decade, both in absolute numbers and as rates, this region continues to have the highest abortion rates in the world. Concerted efforts by governments, professional associations, and international donors are needed to reduce the consequences of unsafe abortion.

Racial Differences in Vasectomy Utilization in the United States: Data From the National Survey of Family Growth

To explore whether health care, socioeconomic, or personal characteristics account for disparities observed in the utilization of vasectomy. More than 500,000 vasectomies are performed annually in the United States. The safety and efficacy of vasectomy make it a good family planning option, yet the factors related to use of male surgical sterilization are not well understood. In this analysis, we examined differences in vasectomy rates according to factors such as race and socioeconomic status. We analyzed data from the male sample of the 2002 National Survey of Family Growth to examine the use of vasectomy among the sample of men aged 30-45 (n = 2161). Demographic, socioeconomic, and reproductive characteristics were analyzed to assess associations with vasectomy. About 11.4% of men aged 30-45 years reported having a vasectomy, representing approximately 3.6 million American men. Although 14.1% of white men had a vasectomy, only 3.7% of black and 4.5% of Hispanic men reported undergoing vasectomy. On multivariate analysis, a significant difference in the odds of vasectomy by race/ethnicity remained, with black (odds ratio = 0.20, 0.09-0.45) and Hispanic men (odds ratio = 0.41, 0.18-0.95) having a significantly lower rate of vasectomy independent of demographic, partner, and socioeconomic factors. Having ever been married, fathering 2 or more children, older age, and higher income were the factors associated with vasectomy. After accounting for reproductive history, partner, and demographic characteristics, black and Hispanic men were less likely to rely on vasectomy for contraception. Further research is needed to identify the reasons for these race/ethnic differences and to identify factors that impede minority men's reliance on this means of fertility control.

Demographic Effects of Breastfeeding: Fertility, Mortality, and Population Growth

This article reviews the demographic effects of breastfeeding on fertility and child survival and, ultimately, on population growth. Extended breastfeeding both reduces fertility by prolonging birth intervals and increases child survival through improved nutrition, especially where adequate substitutes are not available. The results presented show, however, that although breastfeeding is a major determinant of fertility in the absence of other means of fertility control, prolonged breastfeeding alone cannot reduce fertility to levels consonant with slow or zero population growth. The benefits, at least for the first year of life, demonstrate the need for policies that promote breastfeeding and encourage compatibility between breastfeeding and other aspects of women's fives. In particular, policies are needed that permit women to breastfeed their children while, at the same time, improving their socio-economic circumstances through participation in the labour force.

Abortion in Vietnam: Measurements, Puzzles, and Concerns

This report summarizes current knowledge about abortion in Vietnam, drawing upon government statistics, survey data, and fieldwork undertaken by the author in Vietnam throughout 1993 and part of 1994. The official total abortion rate in Vietnam in 1992 was about 2.5 per woman, the highest in Asia and worrisome for a country with a still-high total fertility rate of 3.7 children per woman. Vietnamese provinces exhibited substantial variation in both the rate of abortion and the type of procedures performed. Among the hypotheses explored to explain Vietnam's high rate of abortion are the borrowing of family planning strategies from other poor socialist states where abortion is common; current antinatal population policies that interact with a lack of contraceptive alternatives; and a rise in pregnancies among young and unmarried women in the wake of recent free-market reforms. Because family-size preferences are still declining, abortion rates may continue to increase unless the incidence of unwanted pregnancy can be reduced, a goal that Vietnamese population specialists are seeking to achieve.

Abortion, reproductive rights and maternal mortality.

Women prefer to prevent unwanted pregnancies. Women do not prefer abortion. Unsafe abortion kills and contributes to 40% of maternal mortality worldwide or an estimated 200,000 deaths/year. More than 50% of abortions are performed by unskilled persons. Legal abortion i 11 times safer than childbirth in the USA. About 7 out of 10 women would have an unwanted pregnancy, even if fertility were reduced to 2 births/woman. There are costs beyond death, pain, and suffering of the women themselves; costs are incurred by families and communities and health services. The costs of after care exceed the cost of performing an abortion. Women are frequently denied autonomy to prevent pregnancy. When contraception is denied, the only possible option for women to take control of their lives and destiny is abortion. Male-dominated cultures prescribe the role of woman as procreation and motherhood, without contraception or abortion options. The Roman Catholic encyclical "Veritatis Splendor" espouses such a belief. Women in fact share a multiplicity of roles. Socially sanctioned norms have never been able to control sexual relations, and development initiatives must address functional behavior, rather than idealized behavior. For example, Safe Motherhood programs integrate family planning in educational and health care services, but the emphasis is on contraception among high risk women, and unsafe abortion is ignored. Abortion has not only been viewed as an option for contraceptive failure, but as a means of fertility control. Communist bloc countries frequently provided no other option, except abortion. Poverty and social status were considered tied to access to contraceptive advice and appropriate, safe technology. Poor women may seek unsafe abortion as an inexpensive option; safe abortion even in illegal circumstances can be purchased for those able to afford it. Although rape and incest are socially unacceptable, many countries will not provide abortion even in these circumstances. State funding of abortion may have limits for provision of services only to those in severe mental or physical conditions. Son preference has contributed to the abuse of abortion. The abortion issue should be viewed as an issue of human rights and women's empowerment, and unsafe abortion must be addressed as part of health policy.

Abortion in nineteenth century America: a conflict between women and their physicians.

During the 1800s, male physicians took over women's established sources of medical care and knowledge causing friction between women and their health matters and the rising medical profession. This conflict still exists today. Physicians provided little information on how to prevent pregnancy since to do so would interfere with their natural biologic function of motherhood. Reproduction no longer controlled women who used contraceptives, had an abortion, and those who supported such decisions. Since women had to actively terminate a pregnancy themselves or seek an abortionist, abortion posed a threat to the traditional male dominance of reproductive decisions. Even though no accurate data on the frequently of abortion existed, women often practice abortion in the absence of other means of fertility control. They even helped their fellow sisters by telling them what they can use to induce abortion. These women were often church-going women and well respected in their communities. During most of the century, the clergy did not condemn abortion. There were plenty of agents and materials available to induce abortion which were sometimes publicized as methods to regulate menstruation. Abortifacients included emmenagogues, purgatives, oxytocics, and herbal or botanical products. Yet many proprietary potions did not actually terminate pregnancies. Women often resorted to using sharp instruments, wax candles, penholders with attached wires, glass rods, hair curling tongues, sticks, spoons, knives, and catheters. Physicians during the 19th century did not have the diagnostics means to determine pregnancy so often women misled them so the physicians would perform medical interventions. In the mid-1800s, allopathic physicians strengthened their professional position by regulating physicians and forming the American Medical Association. This resulted in condemnation of abortionists and abortions. They blamed complications of abortion on women's reproductive decisions. The new political climate concerning abortion resulted in regulation of women and their sexuality.

The Sex of previous children and subsequent fertility intention in India

Despite a clear preference for sons among Indian couples most of the earlier studies based on the 1961-1970 data indicate the gender of the child has a small effect on actual or intended fertility. However the research reported herein using rural and urban samples of women interviewed during 1979-80 shows that the sex of womens previous children at each parity has an effect on womens subsequent fertility intentions. This increasing effect of son preference urgently calls for some political interventions influencing the socio-cultural and economic reasons for preferring a son as a means of fertility control. (SUMMARY IN FRE) (EXCERPT)

Sterilization Regret Among U.S. Couples

The 1982 US National Survey of Family Growth included questions aimed at measuring sterilization regret. Of the 8583 couples in the survey who were protected from pregnancy by vasectomy or tubal ligation, 26% indicated they would like to have more children and 10% desire sterilization reversal. The proportion of women who want more children despite sterilization is highest (42%) among those aged 20-29 years, then declines with rising age to a low of 13% among women 40-44 years of age. Of all women who assert they want a reversal, 62% are aged 25-34 years. Blacks comprise 11% of contraceptively sterilized couples in the US but 18% of those who want the procedure reversed; similarly, Hispanics make up 6% of contraceptively sterilized couples but 17% of those expressing a desire for reversal. Significantly higher percentages of Medicaid recipients desire sterilization reversal, although this may reflect the fact that poor women are generally younger. Women who were not currently married were significantly more likely than married women to desire reversal (21% versus 8%). Finally, women who were sterilized before the age of 30 years were significantly more likely than those who were older at the time of the procedure to want another child (33% versus 17%) and to desire reversal (14% versus 6%). It is recognized that the responses to this question are not a good indication of the strength of sterilization regret, and they do not provide an accurate measure of need or potential demand for sterilization reversal. However, these findings do reflect a substantial level of dissatisfaction with sterilization as a means of fertility control. Providers of sterilization services should be aware that 10% or more of their patients may later regret their decision. It is possible that if more acceptable methods of reversible contraception were available, fewer women would resort to sterilization at young ages and the level of regret would be reduced.

Fertility control and the voluntarily chidless: an exploratory study.

SummaryThe widespread availability of effective means of fertility control in many developed countries has made voluntary childlessness a viable alternative to parenthood. Little attention however has been given to the family planning requirements of those who take this minority decision. Data from Scotland suggest that the voluntarily childless have contrasting needs and that usage of and perspectives on contraceptive techniques, sterilization, and abortion depend primarily upon the extent and basis of individual commitment. It is important that those involved in providing family planning services should be aware of the variations in the childless condition and how these might influence individual behaviour in relation to fertility control.

Seminal parameters in rhesus monkeys under physiological conditions and in studies for male fertility control using FSH antibodies or LH-RH-agonists.

To characterize the male rhesus monkey as a nonhuman primate model for human testicular functions, parameters of exocrine and endocrine testicular function were monitored in 16 adult male-rhesus monkeys for 1 and 5 years respectively. Testicular volumes in-season (October-January) were twice as great as in out-of-season animals (March-June). Ejaculations, both spontaneous and electrostimulated, ceased out-of-season. In 37 ejaculates obtained by electrostimulation in-season, sperm counts ranged from 110-1,100 million/ejaculate, 65% of sperm were motile and 60% were normally formed. Testicular histology showed regression of spermatogenesis out-of-season, with the diameter of the tubules being only one third of that in-season. Circannual changes in exocrine testicular function were accompanied by parallel fluctuations in pituitary and endocrine testicular functions, as evidenced by basal hormone levels and the production rate of testosterone, as well as the response to LH-RH throughout the year. As FSH is required for spermatogenesis in rhesus monkeys, we initiated a study on the long-term effects of active immunization against FSH as a possible means of fertility control. After the first 2 years of observation we can conclude that the production of specific antibodies to FSH results in suppression of spermatogenesis (oligospermia and occasional azoospermia) without affecting endocrine function. The lack of adverse side effects may encourage further investigations on this approach to fertility control. LH-RH-agonists exert degenerative effects on testicular function in rats via a down regulation of the pituitary and testis. A 12 week treatment of four adult monkeys in-season with Hoe 766 (Hoechst; 4μg/day for eight weeks, 20μg/day for 4 weeks sc) did not reveal any change in sperm counts or motility, although some pituitary desensitization was evident. It remains to be investigated whether even higher doses may result in a suppression of spermatogenesis.

Sterilisation: the Aberdeen experience, and some broader implications.

In her paper, Sue Teper outlines the various methods of contraception or fertility control and their relationship to sterilisation. She also considers a particular group of women in Aberdeen as a mini case-study. From these two aspects of sterilization develops a third--that of broader medical and economic issues. Sterilisation usually concerns patients who are free from illness, therefore the attitudes of medical personnel are much more relevant to whether or not the operation is performed on request purely as a means of fertility control, rather than for medical reasons where the patient may be at risk were a pregnancy to occur. Ms Teper calls for medical staff in this instance to clarify their own attitudes in decisions which involve surgical skills and healthy patients.

Toward stationary populations and beyond.

The world's rate of population growth is declining. Most industrialized societies have achieved or are moving rapidly toward stationary populations, but while birth rates are also declining in many developing countries, continued growth must be expected because of the large proportions of young people in these populations. New evidence of exceptions to the classical demographic transition theory indicate that declining fertility is compatible with high mortality or low socioeconomic development if acceptable means of fertility control are readily available. "Fertility silhouettes" showing differing age-specific fertility rates indicate that present family planning programs have had a demographic impact. A review of the economic and ecologic consequences of rapid population growth justifies the conclusion that considerable effort will be required to again bring the world's population into balance with these systems. The author outlines priorities for this effort, with emphasis on the need to devise acceptable means of fertility control that will not tax the frail health care infrastructures of developing countries.

Family limitation and age at marriage: fertility decline in Sturbridge, Massachusetts 1730-1850.

Summary This paper examines fertility behaviour in Sturbridge, Massachusetts between 1730 and 1850. The substantial decline in fertility over the period resulted from a combination of a rising female age at marriage and declining fertility within marriage. The authors suggest that declining marital fertility represents the onset of deliberate family limitation and put forward the hypothesis that it is related to the interaction of the culmination of the settlement process and the commercialization of economic life in the early nineteenth century. The change in fertility in Sturbridge, then, is explained by the combination of traditional controls over family formation and new means of fertility control.

Social theory and individual fertility behaviour: Some issues of research orientation

Public and official interest in fertility behaviour and its implications issubstantial. The pattern of reproduction in Britain has changed dramatically since the beginning of this century, and the rate of change has accelerated since the early 1960's, with the availability of new means of fertility control and the development of more permissive attitudes towards social and sexual behaviour. At the same time research commitments in the area have also increased. At least part of the purpose of this research has been to understand how and why fertility desires and behaviour alter. In this respect the research efforts have not been particularly successful. Highly sophisticated (and successful) techniques now exist for documenting and monitoring the trends in fertility and in the use of the various techniques for family limitation. Parallel progress has not occurred in the construction of hypotheses which might “explain” these trends. It is this particular area which now merits attention. In the process of correcting the current imbalance we may come to an improved understanding of the behaviour itself, rather than continually improving the means for describing it.

The role of sterilization in controlling Puerto Rican fertility

Abstract This paper provides evidence that the prevalence of female sterilization in Puerto Rica has increased substantially in recent years. It is estimated that about one-third of all Puerto Rican mothers aged 20 to 49 in 1965 were sterilized. This estimate is based on data from an island-wide survey in 1965 (Master Sample Survey of Health and Welfare). Additional data from this and other sources are analysed, leading to the conclusion that sterilization, rather than any other means of fertility control, was largely responsible for the decline in Puerto Rican fertility since 1950.

Birth Control in Lima, Peru: Attitudes and Practices

There is no official population policy in Peru. The countrys health programs concentrate on morbidity and mortality control and ignore natality. Despite this and the fact that the Catholic Church is forceful and influential in this predominantly Catholic country there are indications that Peruvian families are trying to limit their size. As this information is essential for the planning and adoption of a national population policy a study was initiated to learn the attitudes and practices of the population regarding family planning. An area-cluster sampling method was used and a sample of 500 Peruvian women living in Lima and ranging from 20-39 in age were interviewed in their homes by 12 qualified social workers. The questionnaire used covered general characteristics of the women interviewed and her family and housing conditions menstrual history current and former contraceptive history social and economic level and opinion on family limitation. It was found that abortions are a means of fertility control in Lima and that they are resorted to particularly by women who are of the upper and middle social and economic classes who are over 30 and who already have 3 or 4 children. Results also revealed that women of these same classes use contraception. At the time they were interviewed the proportion of women who were sexually active and who were using contraception was 68% in the upper class 54% in the middle class and 38% in the lower class. Of all methods the condom and rhythm were the 2 most used among all classes. In addition to the condom the upper and middle classes used the rhythm method while the lower class also douched and used coitus interruptus. 78% of the women who gave their religion as Catholic were using a method other than rhythm and coitus interruptus which have the Churchs approval. A majority of women among all classes approved of family planning.

A STUDY IN FERTILITY CONTROL.

It is widely recognized that in many parts of the world there is a “population problem”: the high rate of increase in population makes social and economic development difficult if not impossible. Can anything be done about the problem? Practical means of fertility control are available to individual couples, but can the control of fertility actually be implemented on a large scale in the developing areas? This article will describe an experiment designed to find out what can be done in one of the world’s most densely populated places: the island of Taiwan off the coast of mainland China.